Use of functional electrical stimulation to augment traditional orthopaedic surgery in children with cerebral palsy

Area of Science:

• Orthopaedic Surgery
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Cerebral palsy (CP) often requires surgical intervention to improve lower extremity function.
• Traditional orthopaedic surgery for CP can involve extensive procedures.
• Exploring less invasive alternatives is crucial for patient outcomes.

Purpose of the Study:

• To compare functional outcomes of traditional orthopaedic surgery versus limited surgery augmented with functional electrical stimulation (FES) in children with CP.
• To evaluate the efficacy of FES-assisted rehabilitation in conjunction with reduced surgical intervention.
• To assess the impact on the number of ablative procedures performed.

Main Methods:

• Prospective pretest-posttest control group study with 17 ambulatory children with CP.
• Surgical group (n=9) received traditional orthopaedic procedures.
• FES group (n=8) received limited surgery with percutaneous intramuscular FES electrodes and a home walking program.

Main Results:

• Both groups showed significant improvements in passive range of motion, gait spatiotemporal parameters, and gross motor function one year post-intervention (P < 0.05).
• No significant differences in functional outcomes were observed between the FES and surgical groups.
• The FES group underwent an average of 4.5 fewer ablative procedures per child.

Conclusions:

• Functional electrical stimulation (FES) combined with limited orthopaedic surgery yields comparable functional gains to traditional surgery in children with cerebral palsy.
• This combined approach offers a potential benefit by significantly reducing the number of ablative surgical procedures.
• FES-assisted rehabilitation presents a viable, less invasive alternative for managing lower extremity dysfunction in pediatric CP.